Sierra Leone has bulk of latest Ebola cases; total nears 16,000

As the overall count of Ebola cases approaches 16,000, Sierra Leone is accounting for most of the latest cases and deaths and is likely to displace Liberia soon as the country with the worst numbers, the World Health Organization (WHO) reported today.

In its situation update, the WHO said the global Ebola virus disease (EVD) case count has reached 15,935, including 5,689 deaths. That represents 584 new cases and 230 deaths since the previous update on Nov 21.

Sierra Leone accounts for 409 of the new cases and 131 deaths, according to the WHO figures. Guinea had 87 new cases and 46 deaths, while Liberia reported 82 new cases and 53 deaths. In the past week, the three countries have had a total of 600 new cases, the agency said.

The new numbers include the previously reported total of eight cases in Mali, up from six in the Nov 21 report.

Sierra Leone pace may be increasing

The WHO said case incidence is stable in Guinea and stable or declining in Liberia, but it may be increasing in Sierra Leone. "The total number of cases reported in Sierra Leone since the outbreak began will soon eclipse the number reported from Liberia," the agency added.

Sierra Leone's current official total is 6,599 EVD cases with 1,398 deaths, as compared with 7,168 cases and 3,016 deaths in Liberia. Guinea's totals are 2,134 cases and 1,260 deaths.

New confirmed cases in Sierra Leone last week (to Nov 23) numbered 385, which was down from 533 the previous week, the report says. Intense transmission in the west and north is driving the numbers, the WHO said. The capital, Freetown, remains the hardest-hit area, with 118 new cases for the week.

As for response efforts, the WHO said Guinea is now isolating more than 70% of Ebola case-patients and has more than 80% of the safe-burial teams it needs. On the other hand, it appears that neither Liberia nor Sierra Leone is managing to isolate 70% of patients, but data are up to 3 weeks out of date, the report says.

The three countries report that more than 80% of contacts of known cases are being traced, but the reported numbers suggest that contact tracing is still a challenge in Ebola hot spots, the WHO said.

The agency also reported that three healthcare workers in Guinea contracted Ebola last week. As usual, the WHO said cases and deaths in the epidemic continue to be underreported.

Burial workers strike, get fired

In other Ebola developments, burial workers in Kenema, Sierra Leone, went on strike and abandoned 15 bodies at the city's main hospital, including 2 at the main entrance, the United Nations Mission for Ebola Emergency Response (UNMEER) reported in its own situation update today.

The workers have now been fired for treating the bodies in what an official called a "very, very inhumane way," UNMEER said.

The report also said traditional practices are still hindering the Ebola response, especially when it comes to safe burials. UNMEER field crisis managers in Liberia reported several cases of noncompliance related to burial permits, along with violence toward burial teams. Also, contact tracing and reporting remain difficult, despite the intensification of social awareness efforts in Bomi and Grand Capemount counties, the agency said.

In other Liberian developments, China opened a 100-bed Ebola treatment center in Monrovia yesterday and will start accepting patients next week, UNMEER reported. It will be staffed by Chinese army medics.

"We want to commend China for this exceptional response," said Liberian President Ellen Johnson Sirleaf after touring the center.

Elsewhere, Kouremale, a village on the Guinea-Mali border in Siguiri prefecture, has abandoned its initial resistance to EVD response efforts and is cooperating with responders, UNMEER reported. The village also conducted a safe EVD burial, the agency added.

See also:

Nov 26 WHO situation report

Nov 26 UNMEER report

Nov 21 WHO situation report

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